The role of intraoperative auditory brainstem response testing for infants and difficult-to-test children

详细信息    查看全文

• 作者：Joshua G. Yorgason ; Albert H. Park ; Nanette Sturgill ; Johannes Fredrik Grimmer ; Stephen C. Alder
• 刊名：Otolaryngology - Head and Neck Surgery
• 出版年：2010
• 出版时间：January 2010
• 年：2010
• 卷：142
• 期：1
• 页码：36-40
• 全文大小：414 K

文摘

Objective

To assess the validity of intraoperative auditory brainstem response in infants and difficult-to-treat older children.

Study Design

Case series with chart review.

Setting

Tertiary-level children's hospital.

Subjects and Methods

Twenty-six patients were identified (mean age, 20 ± 18 months) who underwent both intraoperative auditory brainstem response (ioABR) testing and a follow-up hearing evaluation at five (standard deviation 4) months. Ears were analyzed separately for mean threshold change, and a sub-analysis was performed accounting for the presence or absence of fluid at the time of surgery.

Results

A paired t test analysis indicated a statistically significant difference at 1 kHz. There was not a statistically significant difference between the two groups with click or 4-kHz testing. Fifteen ears (58 % ) at 1 kHz and 17 ears (49 % ) at 4 kHz frequencies, however, improved by 10 dB or more; 67 percent and 65 percent of these ears, respectively, had middle ear fluid intraoperatively. Eight ears (35 % ) in the click ABR group had a similar improvement, four of which had fluid at the time of surgery. Four ears in the 1-kHz (11.5 % ), in the 4-kHz (11.4 % ), and in the click ABR group (17.4 % ) demonstrated a 10-dB or worse threshold. The range of the discrepancy varied from a worsening in thresholds up to 20 dB and improvement in thresholds up to 45 dB.

Conclusions

We observed a significant discrepancy between ioABR and follow-up hearing thresholds. If ioABR indicates a hearing loss, audiologic testing should be performed at least several weeks later to confirm the results.